Individual
TALETHA HASKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
830 GRACERN RD, COLUMBIA, SC 29210-7629
(706) 842-5330
(706) 842-5340
Mailing address
525 8TH ST, P.O. BOX 2567, AUGUSTA, GA 30901-9998
(706) 842-5330
(706) 842-5340
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-233888
SC
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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